The Anatomy of Perception

by AJ Rose

  Scrambling, we entered the locker room, where some of the other interns had beat us and were hurrying into their scrubs. Three rows of lockers with benches in front of them took up the majority of the space. Beyond the lockers and through a tiled walkway were two bathroom stalls, and across from those, two curtained off-shower stalls. The lines waiting for a stall for privacy were two-people deep. I looked around uncomfortably. There was no way we could all don our daily uniforms in five minutes if we waited for privacy. The matter-of-fact way the chief and the residents had made it clear we were all nobodies had struck a chord with me, and I felt uncertain and insecure, like I had when I lived with my father’s daily verbal beatdowns. Stripping to my underwear to change in front of others made it more humiliating. It was high school baseball practice all over again, and I was terrified I’d tip someone off by looking at the wrong ass.

  “Oh, for fuck’s sake,” Sabrina muttered, hanging her lab coat on the corner of her open locker and beginning to unbutton her shirt right out in the open. “It’s not like we haven’t all seen the human body before,” she said when she noticed me gaping at her.

  On my other side, Carrie coughed a little and dropped her duffel bag onto the bench. Toeing off her shoes, Sabrina whipped off her blouse to reveal a black lace bra and a colorful Caduceus tattoo on her chest, above her left breast: two snakes entwined around a winged staff, the common symbol for medicine. It was clear she worked out, too. No wonder she wasn’t bothered by changing in front of everyone.

  When she saw me peeking, she grinned wickedly, shaking out her generic blue scrub top. “Get a good look, Silver. I’m not going to be late because of modesty, so I’m sure you’ll see the goods again.”

  Embarrassed, I averted my eyes and sat down to unlace my shoes and toss them in my bag. I was wearing a white t-shirt beneath my dress shirt, so when I pulled the button-down off and donned the scrubs over the undershirt, Sabrina booed.

  “Aw, come on, Silver. We’re all friends here.”

  “No, we’re not,” Carrie said across me with more bite in her words than I’d ever heard from her, hemming me into the conversation. “We’re competition.” I leaned back, uncomfortable and unsure what had gotten into Carrie.

  “Carrie, this is Sabrina Ballard,” I said, hoping an introduction would smooth Carrie’s ruffled feathers. “Sabrina, Carrie Clower.” I made sure to rhyme Carrie’s last name with flower, because she’d had to correct every doctor we’d had in med school at the beginning of each new class rotation. I remembered it had irritated her when it was pronounced wrong. Sabrina held her hand out for Carrie to shake. Carrie took it reluctantly, then pulled her hair into a ponytail while speaking to me.

  “About a minute left. See you out there?”

  I nodded mutely. Around me, interns were dropping their pants everywhere, including those waiting in line. I figured Sabrina was right—what was a little semi-nudity after what we’d all seen while dissecting our cadaver in gross anatomy? I quickly changed into my scrub pants and pulled tennis shoes from my duffel, slipping them on and trying to ignore how close to me Sabrina stood.

  “So, this is going to be fun, right, Silver? Our first day in the ring?”

  I couldn’t help the smile that stretched across my face as I pulled on my white coat and shoved my stethoscope in one pocket and a small notebook and pencil in the other. Not only did I have a piece of paper that said Dr. Dane Perry, but now I looked the part. All that was left was to become the part.

  “I don’t know about fun, but it’ll certainly be interesting. And don’t mind Carrie. She’s probably as nervous as the rest of us. Not to mention, she’s used to being the smartest in the room. She was number one in our class.”

  “Good to know,” Sabrina said, slamming her locker door. “I always like to target the competition, and we are competition, as she said.”

  “Lambs,” I replied, answering her earlier question of whether we were lambs or wolves. She raised a sculpted brow. “I think we’re all lambs going to slaughter, and any competition we have is sort of pointless right now.”

  She stepped over the bench and moved toward the door. I followed, clipping my pager on my waistband. As I stopped alongside her in front of Dr. Kingsley, who was bent over a chart at the nurse’s station, she leaned over and spoke softly.

  “Lambs, wolves. Doesn’t really matter either way. As long as I’m faster, I’m the one feasting and not the one being feasted on.”

  “Doctors, are we ready to begin?” Dr. Kingsley asked. We squared our shoulders and fell quiet, ready for our first day practicing medicine.

  “We’re starting in the ER,” Dr. Kingsley announced. “Many new admissions come in from the pit, and perhaps today we’ll see something interesting. If not, you can observe suturing, run tests for the pit crew, and get your bearings in the hospital by taking patients for testing. Any questions?”

  Sabrina raised her hand like a kid in school vying to become teacher’s pet. Our resident didn’t bother to suppress her reaction, letting out a put-upon sigh. “Yes, Dr….” Kingsley consulted her clipboard. “Ballard?”

  “How long do we have to observe before we get to do sutures and procedures ourselves?”

  “As long as I say you do, until I’m confident you can handle the practical application of what you’ve learned. And not a minute before. Got it?”

  “Yes, ma’am,” said our fourth intern, whose last name was Getty, I remembered from roll call.

  Dr. Kingsley eyed him. “I earned my title just as you have yours, Dr. Getty. I am Dr. Kingsley, or just Kingsley, not ‘ma’am,’ if you please.” Without waiting for a reply, she turned and walked down the corridor, not looking to see if we fell in line behind her.

  “So, this is what it’s like,” Carrie whispered to me as we hurried after our teacher.

  “What?”

  “Being the gum on the bottom of a surgeon’s shoe.”

  I snorted. “Guess so.”

  “Speak for yourselves,” Sabrina said, her volume normal.

  Carrie glared at her. “I already don’t like you.”

  “I’m not here to be liked,” Sabrina breezed, pulling her notepad and pen out of her pocket. “I’m here to learn to cut.”

  “Oh, so saving lives is second to you getting to slice people open?” Carrie asked as we turned a corner. I tried to block them both out and pay attention to where we were going so I wouldn’t get lost in the maze of corridors that made up Elijah Hope.

  “You know, I don’t recall your name, Dr….” Sabrina said to Carrie.

  “What does it matter?” Carrie grumbled. “We’re not friends. You’re here to cut.”

  Sabrina smiled sharply. “I like to know the names of my victims before I crush them.”

  “Okay, okay,” I broke in. If they were going to snipe at each other the whole time, I was going to distance myself from them both. “How are you going to learn anything if you’re too busy comparing egos? God, and they say the men are competitive.”

  Carrie turned away, sticking her nose in the air.

  “May the best surgeon win,” Sabrina said, giving a deferential nod as a karate student would at the beginning of a lesson.

  “Shut up,” Dr. Kingsley said absently as we pushed into the newly renovated emergency department. A bank of workstations made up the middle of a large room with trauma bays on each side. The monitors and equipment bolted to the walls of some of the bays looked strange, poised over empty space where beds or gurneys would go when patients were wheeled in. Most of the curtains were pulled back to the walls, concealing nothing while we stood there and surveyed. Not a lot of activity, for which I was somewhat grateful. At least it wasn’t chaos.

  Dr. Kingsley approached the workstation to speak to the two nurses bringing in the information on the next patients in the waiting room.

  “What have we got?”

  “Mia Nguyen, twenty-five, arrived about half an hour ago with her boyfriend, chief complaint is blood-tinged sputum.”r />
  Dr. Kingsley nodded. “Well, let’s show her back to Shangri-La, shall we?”

  The nurse moved to gather the patient from the ER waiting area and brought a pretty Asian girl to one of the trauma bays with a bed. We stood back while she took the girl’s blood pressure, temperature, pulse, and asked her a series of questions related to her symptoms, as well as her history. Once the formalities were out of the way, Dr. Kingsley looked over the girl’s information, murmuring important points to us as she read.

  “Miss Nguyen is running a low-grade temperature, does not seem to be suffering cold symptoms that would explain excessive raw throat or bloody coughing, and other than being tired all the time, is generally in good health. Right now, we have a mystery, ladies and gentlemen. Let’s see if we can figure out what could be going on with her.”

  We stepped into the trauma bay and circled the end of the bed, the patient looking at us warily as we each studied her as if she were the most interesting puzzle.

  “Hello, I’m Dr. Kingsley.” She then introduced the four of us. “They’ll be assisting me with your case today, if you’re all right with that.”

  “That’s fine,” the girl said meekly as her boyfriend took her hand. “I’m okay anyway. I’m only here because Jake saw blood in my tissue and flipped out.”

  “It’s not normal to cough up blood, Mia,” her boyfriend, Jake, interjected. “I hope you’re right, but humor me, okay?” The guy, probably about Mia’s age, was a little awkward, with a head too big for his skinny body and a protruding Adam’s apple in his slender neck. He had dark hair, cut generically, and wire-frame glasses, which made him geeky in appearance, but without the chic hipster vibe that was popular. The way her face softened, however, made it clear he was her hero.

  “If it’s okay with you, I’d like to examine you now,” Dr. Kingsley said, ignoring their disagreement. Mia nodded and sat straight up while Kingsley listened to her heart and lungs. She followed instructions while the doctor looked in her ears and mouth, and took a sample from the back of her throat with a long-stemmed cotton swab. “First thing I’m going to do is test you for strep throat. After we get the results, we’ll see if there are more tests required. If that’s all it is—” Kingsley squinted at the computer screen to verify drug allergies or lack thereof. “—you get a shot of penicillin in the thigh and get to go home and kick back for a couple days while the drug works. How’s a mini-vacation sound?”

  “Peachy,” Mia grumbled.

  Kingsley turned to us and snapped the plastic cover over the swab, holding it out to Sabrina. “Since you’re such an eager beaver, you can run this to the lab. Wait for the results there. Shouldn’t take them long to run the test.” Sabrina gave a gigantic smile and spun around to flounce from the room. “Wonder if she’ll get lost on the way to the lab,” Kingsley said under her breath. Carrie and I exchanged amused glances.

  A short while later, after Kingsley gave us the tour of the emergency department and supply areas, Sabrina returned with a piece of paper and intrigue in her eyes.

  “Test is negative. It’s not strep.”

  Kingsley read the lab results herself, pursing her lips. “So, what would you do next? Dr. Perry?”

  My heart thudded at being called upon, but my mouth fell open and I managed to stammer out an answer. “Take her for a chest x-ray and run a CBC.”

  “Checking for what?”

  “Well, she could have something as simple as a bleeding ulcer or as complex as a pulmonary embolism or cancer. Her history isn’t clear enough, so the CBC will test for anything unusual in her blood, and the x-ray gives a visual. From there, I’d decide on further tests.”

  “Good. Dr. Perry, you can show Dr. Ballard to the ER’s imaging suite and do the chest films together with the help of the radiology tech on duty. Dr. Ballard, since you’ve been to the lab, you can escort Perry there and wait with bated breath for the blood test results. Throw in a tox screen for good measure. Like to know totally what I’m dealing with.” Kingsley scribbled the orders and gave them to us so we could get started. As we fell into step, Kingsley led Carrie and Getty off to tend to the next patient on the waiting room list.

  “Flip you for drawing blood,” Ballard said.

  “You go ahead,” I said. “Since I just kicked your ass answering Kingsley’s questions, I’ll have some pity on you and let you puncture our very first patient.”

  She smiled then, genuine and bright. “You know, you keep that thinking up, we’ll get along just fine, Silver.”

  “Why do you keep calling me that?”

  “Your eyes,” she said with a wink. “Never seen that color before.”

  I grabbed a sterile package containing the needle, and a couple larger blood tubes from the supply closet. As we returned to the patient, who was docile and cooperative, baring her inner arm to Ballard, I leaned over to watch. She must have practiced, because Sabrina smoothly punctured the vein, filled the blood tubes with what we’d need for the labs, and applied the bandage with assured fingers, despite the adhesive sticking to her gloves at first. I didn’t want to be, but I was impressed.

  “Diabetic mother. I’m used to needles,” she offered by way of explanation.

  “That sucks.”

  While she pocketed the vials of blood, I snagged a wheelchair and together, Sabrina and I got Miss Nguyen through her x-ray with little fuss, observing from behind the partition while the radiology tech did everything. Once the patient was again ensconced in the trauma bay, I followed Sabrina to the lab, where she passed over the paper Dr. Kingsley had hastily checked, as well as the tubes.

  “How long will this be?”

  The lab guy glanced at it. “Maybe half an hour, forty minutes.”

  Sabrina huffed impatiently as if she weren’t new and at the mercy of pretty much everyone in the hospital, and walked a short distance away to a small, isolated alcove with a couple vending machines and a hideous couch. Dropping some change into the machine, she punched the numbers for a bag of M&Ms. Ripping the corner off, she dropped to the couch and sighed, squinting into the bag to pick out a specific color, which turned out to be red. It shocked the hell out of me when she held the bag up in offer.

  “Breakfast?”

  I stared, then moved to the couch and took an M&M. “Not really breakfast food,” I said, popping an M&M in my mouth.

  She shrugged like she didn’t care. “We’re going to spend the next year, at least, being everybody’s bitches. I kind of want to break the little rules so I don’t turn into a stooge.”

  I smiled. “My best friend, Holly, does the same kind of thing. Whenever one of us has an epically bad day, we go to a decent restaurant. Not some five-star place, or even somewhere you can’t walk in wearing jeans, but not takeout either. We eat whatever, but when we’re through with the entrée, we order every dessert on the menu.”

  Sabrina chuckled. “And you’re picking on me for eating a few M&Ms for breakfast?”

  I shrugged. “The first time, I felt so dumb, like everyone in the place was going to think I was a pig or something. I kept telling her we shouldn’t do it, trying to get her to cancel it. Holly asked, ‘Who made that rule, you can’t order all the desserts? Stupid people, that’s who. Besides, it’s not like we’ll be able to eat them all in one sitting.’ It was kind of brilliant, and did make my day a lot better.”

  “I like it,” she said. “For a once-in-a-while thing, why can’t you, right?”

  “Exactly.” My pocket vibrated and I dug my phone from my scrub pants. I had a text from Craig.

  Craig: Hope your first shift is going well, Doctor. If you mess up, you can practice on me when you get home.

  Amused, I replied, So far, so good. The valedictorian from school got assigned the same resident. I’m not being tortured alongside complete strangers.

  Craig: Glad things are working out. I’ll miss you tonight. Big lonely bed.

  Yeah, this was going to suck, having to get used to sleeping without him sometimes. As I
pondered my reply, I became aware of Dr. Ballard surreptitiously reading over my shoulder and any warm, fuzzy thoughts Craig had brought up fizzled as the lightning crack of fear zipped through me.

  “What are you doing?” I demanded. How much did she see? How fucked am I now?

  She smiled innocently. “I just wanted to see what would bring such a lovesick look to your face. Is she also a doctor?”

  Not that fucked. I released a held breath. “No, an artist. Animator.”

  Her expression turned from indulgent to fascinated. “Really? That is so cool. Been together long?”

  “Three years.”

  “And you haven’t married her yet?”

  I can’t. As far as I was aware, Proposition 8 had passed the year before in California, and in my admittedly sparse knowledge of the equal marriage fight, Massachusetts was the only other state where I could marry Craig. While it wasn’t out of the question conceptually, it was out of the question in my mind. I couldn’t be that publicly open, even for someone I loved as much as Craig. Not if it meant I could be found, and one or both of us could be hurt.